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UNIVERSITY DERMATOLOGY AND VEIN CLINIC LLC NPI 1194270637


NPI Information

NPI: 1194270637
Provider Name: UNIVERSITY DERMATOLOGY AND VEIN CLINIC LLC
Classification: Dermatology - 207N00000X
Entity Type: Organization

CLIA Number: 14D2001027

Address:
8110 CASS AVE
DARIEN, IL
ZIP 60561
Phone: (773) 351-2862
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UNIVERSITY DERMATOLOGY AND VEIN CLINIC LLC is a dermatology in Darien, IL. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. UNIVERSITY DERMATOLOGY AND VEIN CLINIC LLC NPI is 1194270637. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

8110 CASS AVE
DARIEN, IL
ZIP 60561-013
Phone: (773) 351-2862

The provider's authorized official is Vassilios Athanasios Dimitropoulos .
The authorized official title is Physician/ Owner/ President and has the following contact phone number (773) 351-2862.

The CLIA number assigned to this NPI record is 14D2001027 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 8/24/2016 and was last updated on 8/24/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207ND0101XDermatologyMOHS-Micrographic SurgeryNo
2207NS0135XDermatologyProcedural DermatologyNo
3207N00000XDermatologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1I39241MEDICARE UPINILLINOIS
21194838045MEDICAIDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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